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Individual

DIONTE CHARLES VANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
585 MOLLY LANE, WOODSTOCK, GA 30189, WOODSTOCK, GA 30189
(877) 288-4760
Mailing address
585 MOLLY LANE, WOODSTOCK, 30189, WOODSTOCK, GA 30189

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/19/2024
Last updated
07/19/2024
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